Treatments for Hypospadias in Children

Contact the Department of Urology

It's entirely natural that you might be concerned, right now, about your child's health; a diagnosis of hypospadias can be frightening. But you can rest assured that, at Boston Children's Hospital, your child is in good hands. Our physicians are bright, compassionate and committed to focusing on the whole child, not just his condition—that's one reason our urology department is frequently ranked as one of the best among U.S. pediatric hospitals.

Surgery can correct hypospadias and give your child a normal-looking, fully functional penis. In most cases, the procedure is relatively simple and boys make full recoveries within six months or so.If your son has a very mild form of hypospadias, he may not need surgery because his condition is unlikely to affect his future as a husband and a father. But otherwise, a pediatric urological surgeon can perform the procedure to correct the hypospadias, ideally when your son is between 4 to 6 months old.

Surgery

There are a number of different techniques your child's surgeon may use. We will discuss these with you, and answer any questions you might have, while planning the surgery best suited to correct your son's hypospadias. But whatever the individual techniques may be, the surgeon will be working toward three main goals:

to reposition the opening of urethra at the tip of the penis (urethroplasty)

to straighten the penis, if chordee is present (orthoplasty)

to improve the outward appearance of the penis (removing the hooded foreskin)

Your son will receive general anesthesia for the procedure, which typically lasts one-and-a-half to two hours. Most of the time, the surgeon will complete the repair in one session. Some of more severe cases, however, require two sessions spaced about six months apart.

And though the prospect of surgery may feel daunting for some parents, Children's has extensive experience and a very high success rate with hypospadias repair.

After surgery

Depending on the extent of surgery, your child may either go home the same day or stay in the hospital overnight. The Children's nurses will talk with you how to care for him at home and will provide detailed instruction sheets (how to manage his dressing, what activities should be avoided, etc.).

For your child's recovery period, your doctor may prescribe any or all of the following:

acetaminophen (Tylenol), to help ward off soreness in the first few days after surgery

antibiotic ointment, to be applied to the penis several times a day

oral antibiotics

antispasmodic medication, to alleviate bladder spasms

Also, your son's surgeon will likely have inserted a soft drainage catheter, or stent, into the new urethra during the procedure. The stent will remain in your child's urethra (you will be able to see the tip) to hold it open while it heals and to allow urine to drain from the bladder.

Follow-up care

Your child's doctor will remove the stent during a follow-up appointment 7 to 10 days after the surgery.

You and your son will return to see your doctor a month after the surgery, and then again a few months later, so we can make sure the healing is coming along. You typically can expect to see the full results of successful surgery within six months.

Coping and support

We understand that hypospadias can be disruptive and frightening—not only for your child, but for your whole family. From your first visit, you'll work with a team of professionals who are committed to supporting you. There are a variety of resources at Children's to help you and your family:

Patient education: From the office visit to pre-op to the recovery room, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have—How long will I be separated from my child during surgery? What will the operating room be like? They will also reach out to you by phone, continuing the care and support you received while at Children's.

Parent to parent: Want to talk with someone whose child has been treated for hypospadias? We can often put you in touch with other families who have been through the same procedure that you and your child are facing, and share their experience.

Faith-based support: A diagnosis of hypospadias may affect how and when your son is circumcised. If this is a religious consideration for you, or if you are simply in need of spiritual support, we will help connect you with the Children's chaplaincy.

Social work: As part of Children's broader social work program, our pediatric urology department has a dedicated professional who has helped many other families in your situation. Your social worker can offer counseling and assistance with issues such as coping with your child's diagnosis; dealing with financial difficulties; and finding temporary housing near the hospital if your family is traveling to Boston from another area.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”